Coolspring Power Museum

Membership/Contribution Form

Company Name: ____________________________________

Home Phone: ______________________

Name: ____________________________________

E-mail: ______________________

Street: ____________________________________

 2nd E-Mail: ______________________

City: ____________________________________

Cell Phone: ______________________

State: ____________  Country:   ______________

Work Phone: ______________________

ZIP code or International Code:  ______________

Fax: ______________________

Do you wish your name to be kept confidential? If you answer yes, your name will not be printed in the museum's Friends Directory: (Yes or No):_________
Expertise/Occupation/Skill you could volunteer to the museum:___________________________________
_______________________________________________________________________________________

 Please check one:

 ANNUAL MEMBERSHIPS DUES   LIFE MEMBERSHIPS DUES - One Time Contribution

Annual Friend Dues - $30

Patron $1,000

Annual Family Friend Dues - $40

Cornerstone Patron $5,000 - $9,999

 

Endowment Patron $10,000 and up

Membership Dues Amount from Above

  $

Additional Amount for the General Operating Fund

  $

Additional Amount for the 600 hp Snow Fund

  $

Additional Amount for the Endowment Fund

  $

International Processing Fee*

  $

Other

  $

Total Enclosed

  $

Send with remittance to:

Coolspring Power Museum
c/o Gail Lavender
179 Coolspring Road
Coolspring, PA 15730

The official registration and financial information of Coolspring Power Museum may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania, 1-800-732-0999.  Registration does not imply endorsement.

*International Members: Please add a $15 fee to cover the fee our bank charges
to process your non-US$ checks.

 

Copyright 2017 by Coolspring Power Museum